Hyperhidrosis Treatment Q&A
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Botox for Hyperhidrosis - Didn't Work for Me 3 Times. Why?

asked 1 year ago by audmcq in alexandria, va
Latest answer by Michael L. Maris, MD
Question viewed 998 times
Tags: under arms, failure, results

I had my first injections about 2 yrs ago and they didn't work. I then had my second set about 5 months later and still it didn't work. I had my second set 3 days ago and I'm still sweating. I believe my first 2 injection i got a total of 24 injections and the last time I had a total of 40. What's going on? Why didn't it work? Also how I think I have a resistant bacteria under my arms because nothing gets rid of the odor and its over powering. Is there anything I can do for that?

16 answers to Botox for Hyperhidrosis - Didn't Work for Me 3 Times. Why?

+1

Try miraDry

MiraDry is the answer to excessive underarm sweating. Lasting results with only 2 treatments. It is a quick in-office procedure. see video
Michael L. Maris, MD

Dallas Dermatologic Surgeon
+1

Why Botox for hyperhidrosis might not work: missing the target depth!

The injection depth for hyperhidrosis is less than for cosmetic treatment of wrinkles on the face. On the face, the muscles of expression lie totally beneath the level of the skin, and under the arms, the Botox should be aimed at the tiny, tiny muscles that control the openings of sweat glands, which are actually inside the skin more superficially. If you had the same doctor inject you all three times, it is possible this injector was injecting a little too deep and really missing the... more
Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon
+1

Treatment of Hyperhidrosis

If you have had a treatment failure, you likely did not have enough Botox injected. You say that you had 40 units injected total. To have a positive effect, you likely need at least 50 units injected per side for a total of 100 units. Good Luck. see video
David Shafer, MD

New York Plastic Surgeon
+1

Botox for Hyperhidrosis - Didn't Work for Me 3 Times. Why?

Regarding: "Botox for Hyperhidrosis - Didn't Work for Me 3 Times. Why? I had my first injections about 2 yrs ago and they didn't work. I then had my second set about 5 months later and still it didn't work. I had my second set 3 days ago and I'm still sweating. I believe my first 2 injection i got a total of 24 injections and the last time I had a total of 40. What's going on? Why didn't it work? Also how I think I have a resistant bacteria under my arms... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Botox and hyperhydrosis

Botox usually is an excellent treatment for hyperhydrosis.  Although you may have a resistance it is very unusual.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Consider surgical options for axillary hyperhidrosis if Botulinum toxin (Dysport and Botox) doesn't work

There are surgical options for hyperhiudrosis that invoive severing the sympathetic nerves thar stimulate the production of sweat.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Botox for hyperhidrosis usually works very nicely

Botox for hyperhidrosis usually works very nicely. It can take up to 2-3 weeks to get the final result. It takes longer for wrinkle correction. There are a rare group of people who have antibodies to BOTOX and for them BOTOX Cosmetic might not work. It’s more likely that the dose you have been getting is not high enough for hyperhidrosis. You usually need at least 60 units per side and can go up to 80. If raising the dosage does not work, you can also try Dysport or Xeomin. These... more
Joseph A. Eviatar, MD

Bronx Oculoplastic Surgeon
+1

Botox for Hyperhidrosis

Botox works wonders for Hyperhidrosis.  Your response is very unusual.  I recommend you return to the last physician, presumably a board certified physician, who performed your injections and be evaluated.  You may require some additional injections/units to get an optimal result. As for the odor, topical antibiotic and prescription antibiotic washes may be necessary.  Again, your physician should help with these.
Lisa Kates, MD

Annapolis Dermatologist
+1

Botox for hyperhydrosis

It's unusual that your treatment didn't work.  I would talk to your doctor and ask him how many units of botox were used.  Is it just sweat or do you have any pus draining.  If you have chronic infections or pus in your armpit - you may have a different problem that would need a more invasive treatment.  Definitely ask your surgeon to help you understand your treatment and your overall plan! Dr. Cat Begovic M.D.
Catherine Huang-Begovic, MD

Beverly Hills Facial Plastic Surgeon
+1

Underarm sweating & Botox

Botox invariably works for hyperhidrosis. Have your doctor perform the starch-iodine test before the injection & repeat in 2-4 weeks. This test shows visibly how much sweat is being produced.If you receive 50 units [or more] in each arm pit, the Botox should work. The test will document the degree of improvement.  
Khaled El-Hoshy, MD

Detroit Dermatologic Surgeon
+1

Botox injections for hyperhidrosis

Botox is injected superficially and about 50 units per axilla (undearm). After the treatment, a starch iodine test can reveal the persistent areas that still produce sweat and these areas can be retreated. If none of the areas respond, then there truly is something unique about your metabolism and sweat production. You should then see a board certified dermatologist.
Ronald Shelton, MD

Manhattan Dermatologist
+1

Why didn't Botox work for underarm sweating?

The question is was Botox completely ineffective or was it just partially effective in decreasing sweating. There are several reasons for why Botox may be just partially effective: 1. The number of units used was not sufficient. I use the entire 100 unit vial for both underarms. 2. The area that was injected is not the area where the sweating happens.  In that case, what you need is a starch-iodine test, which will clearly show the area where the sweating happens. ... more
Emily Altman, MD

Short Hills Dermatologic Surgeon
+1

Hyperhidrosis Normally Responds Well to Botox

When Botox is used for cosmetic purposes, it is easy to tell whether the injection worked or not.  The muscle treated is either contracting or it is not.  It is a little harder with treatment of hyperhidrosis but it is possible to get the same objective evidence with a starch-iodine test.  Physicians who are REALLY interested in helping you will do this test to determine where to treat you and whether the injections were successful.  The problem... more
Joseph Campanelli, MD

Minneapolis Facial Plastic Surgeon
+1

Most people love Botox for excessive underarm sweating.

I'm not sure why you didn't get any response to underarm Botox. Just about everyone I've treated loves the result that tends to last up to 6 mos. Check with your doctor how many units of Botox you received. I use a total of 100units for both underarms. If other deodorants are not helpful, try a salt-stick (Potassium alum). These are available at Whole Foods. After you shower, you apply the salt stick and this kills most odor causing bacteria. I hope this is helpful... more
Eric M. Joseph, MD

West Orange Facial Plastic Surgeon
+1

Botox for Hyperhidrosis

Hi Aud, I know, it's the pits!  Botox is usually very effective at treating hyperhidrosis.  Hopefully you have gone to three different physicians, in which case you may be resistant.  If you have been to the same physician, then I would question the technique and the dosage of Botox units used.  You should get 50 units into each arm pit.  In the meantime, buy a few bars of Irish Spring soap, for that strong stench that other soaps can't touch.  Good... more
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+1

Botox Doesn't Work

I do not inject Botox or Dysport for sweating, but I have a lot of experience with both for wrinkle reduction. There are some people who do not respond to Botox. The first thing to check is if everyone who was treated with the vial used is having the same problem. If so the problem is with the vial not the patient.  If everyone else who was treated with the same vial has good results, then the problem may be with resistance in the patient. Some patient require higher doses, and... more
Joseph Mele, MD

Walnut Creek Plastic Surgeon

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